Implementation of the measure of case discussion complexity to guide selection of prostate cancer patients for multidisciplinary team meetings

Sep 24, 2026

Background: Multidisciplinary team meetings (MDTMs) support individualized, evidence-based cancer care, but rising patient volume and treatment complexity strain MDTM resources and drive demand for case prioritization. Decision aids could standardize and streamline complexity assessment. This study validates the Measure of Case Discussion Complexity (MeDiC) in a new healthcare setting and diagnostic area to enable structured case input for complete MDTM discussions. Methods: MeDiC (26 items) was applied to 364 Swedish men with newly diagnosed prostate cancer and correlated with clinical parameters and referral behavior.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

MDT in cancer care

Challenges and need for prioritization

DOI: 10. 1002/cam4 .6189 RESEAR CH ARTICLE Implementation of the measure of case discussion complexity to guide selection of prostate cancer patients for multidisciplinary team meetings Jessica Wihl1,2,3 | Victor Falini2 | Sixten Borg2,4 | Olof Stahl1,2,3 | Thomas Jiborn2,5 | Bjorn Ohlsson2 | Mef Nilbert1,3 1Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden 2Regional Cancer Centre South, Region Skåne, Lund, Sweden 3Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden 4Health Economics Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden 5Department of Urology, Skåne University Hospital, Malmö, Sweden Correspondence Jessica Wihl, Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden. [Email:](Email: jessica.wihl@med.lu.se)[ jessica.wihl@med.lu.se](Email: jessica.wihl@med.lu.se) Abstract Background: Multidisciplinary team meetings (MDTMs) provide an integrated team approach to ensure individualized and evidence-based treatment recommendations and best expert advice in cancer care. A growing number of patients and more complex treatment options challenge MDTM resources and evoke needs for case prioritization. In this process, decision aids could provide streamlining and standardize evaluation of case complexity. We applied the recently developed Measure of Case Discussion Complexity, MeDiC, instrument with the aim to validate its performance in another healthcare setting and diagnostic area as a means to provide cases for full MDTM discussions. Methods: The 26-item MeDiC instrument evaluates case complexity and was applied to 364 men with newly diagnosed prostate cancer in Sweden. MeDiC scores were generated from individual-level health data and were correlated with clinicopathological parameters, healthcare setting, and the observed clinical caseselection for MDTMs. Results: Application of the MeDiC instrument was feasible with rapid scoring based on available clinical data. Patients with high-risk prostate cancers had significantly higher MeDiC scores than patients with low or intermediate-risk cancers. In the total study, population affected lymph nodes and metastatic disease significantly influenced MDTM referral, whereas comorbidities and age did not predict MDTM referral. When individual patient MeDiC scores were compared to the clinical MDTM case selection, advanced stage, T3/T4 tumors, involved lymph nodes, presence of metastases and significant physical comorbidity were identified as key MDTM predictive factors. Conclusions: Application of the MeDiC instrument in prostate cancer may be used to streamline case selection for MDTMs in cancer care and may complement clinical case selection. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. 1 | INTRODUCTION KEYWORDS comorbidity, decision aid, multidisciplinary team, tumor board, prostate cancer referral guidelines with selection of complex cases for full MDTMs. In several diagnostic areas, including prostate In cancer care, the multidisciplinary team (MDT) approach has developed into standard of care with the aim to formulate an individualized, evidence-based and relevant treatment recommendation. MDT-based decision-making increase likelihood for treatment according to guidelines and provide best expert opinion based on interdisciplinary and multiprofessional case evaluations and discussions. Multiple studies support an impact from MDT-based case discussions on treatment plans and patient management, though the outcome differs between diagnoses and is influenced by tumor-related as well as patient-related factors such as stage, tumor biology, comorbidity, d

FAQs

What problem does MeDiC aim to address in MDTMs for prostate cancer?

MeDiC addresses resource constraints caused by increased patient numbers and more complex treatment options by enabling standardized evaluation of case complexity for prioritization in MDTMs.

How was the Measure of Case Discussion Complexity (MeDiC) studied in this research?

The 26-item MeDiC instrument was applied to 364 Swedish men with newly diagnosed prostate cancer, producing scores from individual-level health data that were correlated with clinicopathological parameters and MDTM referral behavior.

Which factors predicted MDTM referral in the study’s comparisons?

Population affected lymph nodes and metastatic disease influenced MDTM referral, while comorbidities and age did not. In individual-patient comparisons, advanced stage, T3/T4 tumors, involved lymph nodes, metastases, and significant physical comorbidity were identified as key predictive factors.

Sep 24, 2026

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